BYFO 2012 Fall Tackle Registration Form

Bastrop Youth Football Association
PO Box 847
Bastrop, Texas 78602
http://www.bastropfootball.org
512-551-0401

Player Information

* Player First Name

* Player Last Name

Age

* DOB

Sex

Grade

* Pant Size

* Jersey Size

* Early Registration is $135 and ends April 31st. Regular Registration is $165 for the first child and each subsequent children is $135 each.

If registering AFTER July 1st you will be assessed a $25 late registration fee.

Total fee for this participant:

* I would like to attend the Bear Summer Camp before the season.

Our one week summer camp is $25 per child and is not included in the price of the fall season registration. There are no sibling discounts or scholarships awared for Summer Camp. You can pay for summer camp in advance by adding $25 to your registration or by bringing a check or money order to the first day of camp. You may also make payments for summer camp online.

Household / Adult Primary Contact

* Relationship to Participants:

* Parent First Name

* Parent Last Name

* Address 1

Address 2

* City

* State

* Zip

* Phone: Home | Cell | Work

Phone 2: Home | Cell | Work

* Email Address

Please email me updates

Secondary Parent or Guardian Information:

First Name (Adult 2)

Last Name (Adult 2)

Phone Adult 2

Emergency Contact (Other than Parents) Name and #:

* First Name

* Last Name

* Phone

I am interested in coaching?

Yes - I would like to be a coach

No - I would not like to coach

Terms and Conditions

I am the parent/guardian of the above said participant. I give my approval for said participant to participate in any and all football/cheerleading activities.

I understand that participation in football/cheerleading may result in serious injury. I do hereby waive, release, absolve, indemnify, and agree to not hold Bastrop Youth Football Organization, the organizers, board members, sponsors, coaches, supervisors, officials, participants and/or any person transporting my child to and from activities for any claim arising out of an injury to my child, whether the result of negligence or for any other cause except to the extent and the amount covered by accident or liability insurance.

I understand that I must return a signed Parent Behavior Form along with the completed Registration Form. I understand that my child will not be able to participate until all completed paperwork and payment is provided.

I understand that no refunds will be given.

Please insert any comments or questions below:

* By clicking this check box, I attest that I have read and agree to registration. I understand that all fees related to registration are due at this time.

I agree to the terms and conditions

Admin Information

* Indicates Response Required